Codes Library
Every code the suggestion engine draws from, with the plain-language description.
Procedures — CPT & HCPCS
99401Preventive counseling ~15mPreventive medicine counseling, individual, approx 15 minutesCPT
99402Preventive counseling ~30mPreventive medicine counseling, individual, approx 30 minutesCPT
99403Preventive counseling ~45mPreventive medicine counseling, individual, approx 45 minutesCPT
99404Preventive counseling ~60mPreventive medicine counseling, individual, approx 60 minutesCPT
98960Self-management education, individualEducation/training for patient self-management, individual, each 30 minutesCPT
98961Group education, 2–4 patientsEducation/training for patient self-management, group of 2–4, each 30 minutesCPT
98962Group education, 5–8 patientsEducation/training for patient self-management, group of 5–8, each 30 minutesCPT
S9443Lactation class/support, per sessionLactation classes / support service, non-physician provider, per sessionHCPCS
G0513Prolonged preventive, first 30mProlonged preventive service, outpatient, first 30 minutes beyond baselineHCPCS
G0514Prolonged preventive, addl 30mProlonged preventive service, outpatient, each additional 30 minutesHCPCS
99202Office E/M, new, 15–29mOffice/outpatient visit, new patient, 15–29 minutesCPT
99203Office E/M, new, 30–44mOffice/outpatient visit, new patient, 30–44 minutesCPT
99204Office E/M, new, 45–59mOffice/outpatient visit, new patient, 45–59 minutesCPT
99205Office E/M, new, 60–74mOffice/outpatient visit, new patient, 60–74 minutesCPT
99212Office E/M, est, 10–19mOffice/outpatient visit, established patient, 10–19 minutesCPT
99213Office E/M, est, 20–29mOffice/outpatient visit, established patient, 20–29 minutesCPT
99214Office E/M, est, 30–39mOffice/outpatient visit, established patient, 30–39 minutesCPT
99215Office E/M, est, 40–54mOffice/outpatient visit, established patient, 40–54 minutesCPT
99341Home E/M, new, 20mHome or residence visit, new patient, approx 20 minutesCPT
99342Home E/M, new, 30mHome or residence visit, new patient, approx 30 minutesCPT
99343Home E/M, new, 45mHome or residence visit, new patient, approx 45 minutesCPT
99344Home E/M, new, 60mHome or residence visit, new patient, approx 60 minutesCPT
99345Home E/M, new, 75mHome or residence visit, new patient, approx 75 minutesCPT
99347Home E/M, est, 15mHome or residence visit, established patient, approx 15 minutesCPT
99348Home E/M, est, 25mHome or residence visit, established patient, approx 25 minutesCPT
99349Home E/M, est, 40mHome or residence visit, established patient, approx 40 minutesCPT
99350Home E/M, est, 60mHome or residence visit, established patient, approx 60 minutesCPT
A0021Travel / mileage (non-covered)Ambulance/transport-style travel allowance used for portal-to-portal travel (non-covered)HCPCS
99199Unlisted service (travel)Unlisted special service/report — used for non-covered travel adjustmentCPT
TRAVELTravel fee line itemTravel fee — portal-to-portal, non-covered by insuranceHCPCS
Modifiers
33 · Preventive
Preventive service under ACA guidelines — waives copay/deductible
25 · Separate E/M
Significant, separately identifiable E/M on the same day as another service
95 · Telehealth (video)
Synchronous telemedicine service via real-time audio/video
GT · Telehealth (interactive)
Via interactive audio and video telecommunications system
Place of Service
11Office
12Home visit
02Telehealth — patient outside home
10Telehealth — patient in home
Diagnoses — ICD-10-CM
O92.01Retracted nipple associated with lactationMaternal
O92.11Cracked nipple associated with lactationMaternal
O92.21Sore nipple associated with lactationMaternal
O92.3Agalactia — complete absence of milk productionMaternal
O92.4Hypogalactia — insufficient milk supplyMaternal
O92.5Suppressed lactationMaternal
O92.6GalactorrheaMaternal
O92.70Unspecified disorder of lactationMaternal
O92.79Other disorders of lactation (oversupply, hyperlactation)Maternal
O91.13Abscess of breast associated with lactationMaternal
O91.23Nonpurulent mastitis associated with lactationMaternal
Z39.1Encounter for care and examination of lactating motherMaternal
Z39.2Encounter for routine postpartum follow-upMaternal
P92.1Vomiting / regurgitation in newbornInfant
P92.2Slow feeding of newbornInfant
P92.3Underfeeding of newbornInfant
P92.4Overfeeding of newbornInfant
P92.5Neonatal difficulty in feeding at breastInfant
P92.6Failure to thrive in newbornInfant
P92.8Other feeding problems of newbornInfant
P92.9Feeding problem of newborn, unspecifiedInfant
R63.30Feeding difficulties, unspecifiedInfant
R63.31Pediatric feeding disorder, acuteInfant
R63.32Pediatric feeding disorder, chronicInfant
R63.39Other feeding difficultiesInfant
R63.4Abnormal weight lossInfant
R62.51Failure to thrive (child)Infant
R62.52Short stature / poor weight gainInfant
Q38.1Ankyloglossia (tongue-tie)Infant
Q38.0Congenital malformations of lips (lip-tie)Infant
Q35.9Cleft palate, unspecifiedInfant
Q37.9Unspecified cleft palate with cleft lipInfant
Z00.110Newborn health examination, under 8 days oldInfant
Z00.111Newborn health examination, 8–28 days oldInfant
Z00.121Routine child health exam with abnormal findingsInfant
Z00.129Routine child health exam without abnormal findingsInfant
Z71.88Encounter for counseling for socially unacceptable / infant feeding counselingInfant